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Biomedical subjects

A Yajima

Publications and source records attributed to A Yajima.

At least 145 records · Page 8Linked to original sources
PubMed1995

Evaluation of the effectiveness of cervical cancer screening: a case-control study in Miyagi, Japan.

To estimate the effectiveness of screening for invasive cervical cancer, a case-control study was performed in Miyagi, Japan. A total of 198 cases (129 mass screen-detected and 69 outpatient-detected) of invasive cervical cancer were identified between 1984 and 1990. The results of the Papanicolaou smear of these cases were compared to those of 396 age- (+/- 5 years) and area-matched controls. Compared with women who had no prior screening (cases 51.6%, controls 16.2%), women who were screened had an odds ratio (OR) for invasive cervical cancer of 0.14 (95% confidence interval [CI] 0.088-0.230). The OR for the 175 cases of squamous cell carcinoma was 0.13 (95% CI 0.077-0.215), while the OR for the 23 cases of screened women with adenocarcinoma was 0.40 (95% CI 0.091-1.753). The time intervals following the last negative smear were assessed and we found an OR for a one-year interval and a two-year interval of 0.09 (95% CI 0.055-0.163) and 0.17 (95% CI 0.083-0.335), respectively. In conclusion, screening for invasive cervical cancer is not only effective but also the degree of protection is high for one to two years.

Adenocarcinoma↗
PubMed1995

Sperm motility characteristics and pregnancy outcome of artificial insemination with husband's semen for male infertility.

What parameter of semen has influence on the pregnancy outcome of artificial insemination with the husband's semen (AIH) with washed sperm for male infertility was investigated. Two hundred fifteen cycles in 62 patients of AIH with washed sperm for male infertility were prospectively studied. We compared six parameters (total sperm count, motility rate, sperm motile efficiency (SME) both before and after washing) in pregnant and non-pregnant cycles. SME of washed sperm was significantly higher in the pregnant than in the non-pregnant cycles (241.0 +/- 68.0 vs. 169.5 +/- 80.0). There were no differences in other five parameters between pregnant and non pregnant cycles. SME, the parameter of sperm motility characteristics, of washed sperm is closely related to the outcome of AIH for male infertility. Sperm motility characteristics after washing may be one of the important indexes of the result of AIH for male infertility.

Adult↗
PubMed1995

[High-dose chemotherapy (HDCT) with peripheral blood stem cell transplantation (PBSCT) in ovarian cancer patients with poor prognosis].

Platinum is a key drug in ovarian cancer chemotherapy. Through combination with peripheral blood stem cell transplantation (PBCST), up to three times the usual carboplatin dose (1,200 mg/m2) may be given. If granulocyte colony stimulating factor (G-CSF) is added to the PBSCH harvest and apheresis is performed twice when the leukocyte count exceeds 10,000/microliters 14 days before and after the platinum-based chemotherapy, the necessary hematopoietic stem cell collection for bone marrow reconstitution can be done. This treatment proves most effective when the initial treatment is under way and it is used as a consolidation therapy for minimum residual disease very similar to PCR or for PCR itself. Forthcoming investigation should determine what impact this therapeutic approach will have on longer survival, or whether it will contribute to treatment of an ovarian cancer with a poor prognosis, for example, when the residual tumor measures more than 2 cm in diameter. Moreover, what results can be expected if one uses effective ip chemotherapy with the standard dose in conjunction with the PBSCT-HDCT combination? Especially, if one can contact the residual tumor in the intraperitoneal cavity most likely to have a recurrence with a drug at an extremely high concentration, enabling a massive dose to the intraperitoneal cavity comparable to the standard dosage by vas internal administration with equivalent blood concentration, distant metastases may also be prevented.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Chemotherapy of uterine endometrial cancer].

In recent years, the incidence of endometrial cancer has tended to increase gradually in Japan. Most cases (early cancer of stage I and II) are treated by hysterectomy alone, and the prognosis has been relatively good. From analysis of the poor prognostic factors in endometrial cancer, we understood that additional therapy is necessary for patients who have the following factors: degree of differentiation: G3; invasion to > 1/2 myometrium; metastases to pelvic or para-aortic lymph node, isthumus-cervix extension; surgical stage III and more. However, for patients with advanced inoperable and recurrent cancer, a radiotherapy, is not so sensitive to endometrial cancer has been used. A first line establish a chemotherapy has not been established either. Various attempts have been made to establish a chemotherapy for endometrial cancer. As a result, adriamycin (ADR) and cisplatin (CDDP) have proved effective as single agents. For patients with early cancer who have the poor prognostic factors mentional above, irradiation and polychemotherapy regimens (CAP and AP) are effective. Since the progression of endometrial cancer is dependent on sex steroid hormones, antitumor effects of Medroxyprogesterone acetate (MPA) are expected to be effective for patients with estrogen receptor (ER) positive and progesterone receptor (PR) positive cancer, or with well-differentiated adenocarcinoma (G1 type) histologically. Although several forms of therapy are capable of inducing objective remission as adjuvant treatment, all treatment for advanced and recurrent disease remains palliative, and responses and survival for patients treated with irradiation and chemotherapy remain short. Furthermore, we should examine new methods such as new drug application of key drugs like ADR and Pt pharmaceutical preparation, improvement of Dose intensity of the key drugs and Biochemical modulation, CPT-11, Taxol and assembly of key drugs, along with the Circadian approach in the light of Biochronology.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Aromatase in human endometrial carcinoma and hyperplasia. Immunohistochemical, in situ hybridization, and biochemical studies.

The expression of P450 aromatase and other steroidogenic enzymes were evaluated in 42 endometrioid endometrial carcinomas, 23 endometrial hyperplasias, and 7 normal endometrial specimens. These findings were correlated with clinicopathological findings to elucidate the possible biological significance of in situ estrogen production in the development of human endometrial carcinoma. Only weak aromatase immunoreactivity was observed in vascular walls and myometrial cells. In contrast, strong aromatase stromal immunoreactivity was observed in 28 of 42 (66.7%) endometrial carcinomas. However, no stromal immunoreactivity was seen in normal or hyperplastic endometrial specimens. Immunoreactivity in the carcinoma stromal cells was significantly increased at sites of invasion. These aromatase-positive cells were immunohistochemically negative for other steroidogenic enzymes involved in estrogen biosynthesis. In situ hybridization studies revealed aromatase mRNA hybridization signals in stromal cells but not in carcinoma cells. The distribution of aromatase mRNA correlated well with the immunohistochemical localization of aromatase enzyme. Quantitation of aromatase activity demonstrated 8.75 +/- 2.75 pmol/hour/mg of protein for endometrial carcinomas (22 specimens) and 0.98 +/- 1.95 pmol/hour/mg of protein for normal endometrial specimens (4 specimens). Aromatase activity was found in both estrogen receptor-positive and -negative endometrial carcinomas. Aromatase did not vary with respect to the menopausal status of patients with endometrial carcinoma. These results suggest that estrogen is produced in situ in endometrial carcinoma but not in benign endometrial lesions. Such locally synthesized estrogen may act on carcinoma cells in a paracrine fashion to promote tumor growth. Additional investigations are necessary, but increased aromatase expression in the stromal cells of endometrial carcinoma may therefore play an important role in the development of human endometrioid endometrial carcinoma.

Adult↗
PubMed1994

Prognostic significance of p53 overexpression in endometrial cancer.

Abnormalities of p53, a tumor suppressor gene, have been considered to play an important role in tumorigenesis. Clinically, overexpression of p53 has been reported to correlate with poor prognosis in several types of tumors. In this study, we examined 221 cases of endometrioid endometrial carcinoma for overexpression of p53 using immunohistochemistry in patients with a median follow-up of 41 months. Immunohistochemical analysis was performed with monoclonal antibody pAb1801. Overexpression of p53 was detected in 47 of 221 cases (21.3%). There was a statistically significant correlation between p53 overexpression and poor prognosis (P < .0001). In the early stages of cancer (stages 1 and 2), p53 was overexpressed in 11 of 22 patients (50%) who died or had a recurrence during follow-up. In contrast, overexpression was detected in only 14.7% of the 156 disease-free patients during the same period (P < .0001). In advanced stages (stages 3 and 4), tumors from patients with recurrent disease had a higher frequency of overexpression (41.2%; 7 of 17) than those of disease-free patients (23.1% 6 of 26). However, the difference between these frequencies was not statistically significant. In multivariate analysis using the Cox proportional hazard model, p53 overexpression was an independent risk factor when compared with clinical stage, nuclear grade, and patient age. Our results indicate that p53 immunohistochemical evaluation of the most common form of endometrial cancer may be useful in identifying cases of aggressive carcinoma, especially in the early stages.

Carcinoma, Endometrioid↗
PubMed1994

Expression of CD44 in normal human versus tumor endometrial tissues: possible implication of reduced expression of CD44 in lymph-vascular space involvement of cancer cells.

Alternatively spliced variants of the CD44 molecule have been found to be associated with invasive and metastatic potential of cancer cells and poor prognosis in several types of carcinoma. We have examined expression of CD44 in normal and cancerous tissues of the endometrium as well as in cell lines established from patients with endometrial cancers by the combination of reverse transcription-polymerase chain reaction and Southern blot hybridization and by cell surface staining with antibodies to CD44. Of eight cancer cell lines tested, two lines, HOOUA and HEC50B, both of which are possibly potential candidates for metastasis, expressed a very small amount of mRNA for CD44. Variant forms of CD44 were expressed in 9 of 11 (81.8%) normal endometria, whereas 8 of 47 (17.0%) endometrial carcinomas showed expression of the variants. Hyperplasia samples displayed the variant expression in 42.9% of specimens (the value was between those of the normal and cancerous cells) and none of 3 in Müllerian mixed tumors. There was a significant difference in frequencies of CD44 variant expression between normal and cancerous tissues. Furthermore, lymph-vascular space involvement of cancer cells was observed to be statistically significant in the CD44-negative group as opposed to the positive group. Reverse transcription-polymerase chain reaction and Southern blot hybridization clearly demonstrated that normal endometrial tissues express the standard CD44 form as well as the variant form. Immunohistochemical examination of normal endometrium revealed that intense staining was seen on the gland cells at the basement membrane side, and less intense staining was seen between the gland cells. These results suggest that CD44 could play important roles in the function of normal endometrium and that reduced CD44 expression might be related to the metastasis of endometrial cancer cells through lymph-vascular space.

Base Sequence↗
PubMed1994

Prenatal diagnosis of congenital cystic adenomatoid malformation of the lung by fetal lung biopsy.

A case of type III congenital cystic adenomatoid malformation of the lung was successfully diagnosed prenatally by fetal lung biopsy. We performed this procedure at 22 weeks of gestation, using a biopsy gun system under ultrasound guidance. The pregnancy was undisturbed by the procedure but as the condition was incompatible with life, an abortion was performed. The diagnosis was confirmed at post-mortem examination. Fetal lung biopsy appears to be a useful method for prenatal diagnosis of fetal lung disorders.

Abortion, Induced↗
PubMed1994

Conservative surgical treatment in cervical cancer with 3 to 5 mm stromal invasion in the absence of confluent invasion and lymph-vascular space involvement.

We have previously reported that simple hysterectomy is adequate therapy for microinvasive carcinoma of the cervix with less than 3 mm stromal invasion (Yajima, A., et al, Am. J. Obstet. Gynecol. 135, 685-688, 1979). However, whether it is possible to effectively treat patients with deeper stromal invasion remained in question. A policy for surgical treatment in patients with 3 to 5 mm invasion has not been standardized. Although radical hysterectomy is usually performed, some authors insist that patients with 3 to 5 mm invasion can be safely treated conservatively. Patients treated with conservative surgery should be carefully assessed because cases with confluent invasion or lymph-vascular space invasion have a greater potential for lymph node metastasis and carry a worse prognosis. Conservative treatment in this study was limited to patients with microinvasive carcinoma with 3 to 5 mm invasion, stage IB occult patients (classified by the FIGO 1973 staging system). The patients were preoperatively diagnosed with either carcinoma in situ or microinvasive carcinoma, and treated by conservative surgery (conization, simple hysterectomy, or extended hysterectomy). Twenty-two patients with 3 to 5 mm invasion but without additional risk factors, i.e., confluent invasion or lymph-vascular space involvement, were followed without postoperative radiation therapy. All patients survived except one (who died of an intercurrent disease) and there were no signs of recurrence of serious surgical complications. The present study with stage IB "occ" subjects suggests that conservative therapy rather than radical hysterectomy can be used in a very carefully selected subset of patients, i.e., in cases with 3 to 5 mm microinvasive carcinoma without additional risk factors, such as confluent invasion and lymph-vascular space invasion.

Carcinoma in Situ↗
PubMed1994

Paracentric inversion of chromosome 14: a case report.

A new case of familial heterozygous paracentric inversion in the long arm of chromosome 14 [inv(14)(q22q32)] is presented. The rearrangement was first ascertained in a fetus examined due to advanced maternal age, and then detected in the father. The phenotypes of the newborn and the father were completely normal. The parents had no history of spontaneous abortion. With reference to previous reports, the risk of clinical abnormalities are discussed for both de novo and familial paracentric inversions of chromosome 14.

Adult↗
PubMed1994

A family with pericentric inversion of chromosome 12.

A heterozygous pericentric inversion of chromosome 12 (inv(12)) was prenatally diagnosed. The breakpoints were localized to p12.3 and q14, resulting in more than one-third of the total length of the chromosome being inverted. The inversions was transmitted from the father whose phenotype was completely normal. The newborn also showed normal phenotype and grew without any clinical problems. The parents had no history of infertility. Based on these facts, it is indicated that pericentric inv(12)(p12.3q14) does not affect phenotype.

Adult↗
PubMed1994

Bilirubin helps to overcome the two-cell block in mouse oocyte cultures.

PURPOSE: In vitro fertilization and culture of mouse oocytes, under normal atmospheric oxygen tension, subjects them to severe oxidative stress. Oocytes from some strains of mice lack the natural protective mechanism that guards them against this oxidative stress and fail to develop beyond the two-cell stage. METHODS: We could overcome the toxic effects of oxygen metabolites by adding 0.2-0.4 mg/dl bilirubin in a lactate-pyruvate culture medium defined by Whitten (1971). Six- to 8-week-old ICR (Institute of Cancer Research) female mice were super ovulated by intra peritoneal injection of 5 IU PMSG (pregnant mare serum gonadotropin) followed by 10 IU hCG 48 h later. The oocytes were collected from the distended fallopian tubes and inseminated with 1-2 million sperm from 3-4-month-old ICR male mice. The eggs were scored at 24, 48, and 72 h after the hCG injection. CONCLUSIONS: With 0.4 mg/dl bilirubin supplement, by the end of 72 h, 82% of the eggs progressed from the two-cell stage to the four-cell stage. Routine inclusion of bilirubin can improve embryo development in vitro.

Animals↗
PubMed1994

Fetal liver biopsy for prenatal diagnosis of carbamoyl phosphate synthetase deficiency.

Carbamoyl phosphate synthetase deficiency is a type of an inborn error of metabolism with a poor prognosis. Carbamoyl phosphate synthetase is a liver-specific enzyme, and its deficiency can only be diagnosed by enzyme assay using liver biopsy specimens. A pregnant woman at risk for carbamoyl phosphate synthetase deficiency was evaluated for the purpose of prenatal diagnosis of the condition. Fetal liver biopsy was performed at the 22nd week of gestation. The results of enzyme assays on fetal liver biopsy revealed normal enzymatic activity and the diagnosis of carbamoyl phosphate synthetase deficiency was ruled out prenatally. Methods and safety of fetal liver biopsy are discussed. Measurements of activity of liver-specific enzymes were evaluated with respect to methodology and manner of assessment. Prenatal diagnosis of deficiencies in liver-specific enzymes, which have hitherto been considered difficult to detect before birth, has now become possible.

Adult↗
PubMed1994

Umbilical venous pressure and Doppler flow pattern of inferior vena cava in the fetus.

Umbilical venous blood pressure (UVP) was measured at fetal blood sampling using cordocentesis in 113 fetuses. Among these, both inferior vena cava (IVC) Doppler flow pattern, when the preload index was set as a parameter of reversed flow, and UVP were measured in 50 fetuses. We evaluated whether direct measurement of UVP, representing fetal central venous pressure, could be replaced by an assessment of reversed IVC blood flow. Normal mean UVP was 4.89 +/- 3.22 mm Hg, whereas no correlation was observed between UVP and gestational week. When the extent of reversed blood flow from the right atrium to the IVC was expressed as a preload index (PLI), there was a significant correlation between the index and UVP (r = 0.463; P < 0.001). When the abnormal range of PLI was set at 0.45, the sensitivity of an estimate of abnormal UVP (more than 1.5 SD plus the mean) was 0.54 and the specificity was 0.89. Measurement of UVP is necessary for the prediction of fetal cardiac function. PLI can be substituted for the UVP measurement. However, PLI should be supplemented with other parameters for an accurate fetal cardiac function evaluation.

Central Venous Pressure↗
PubMed1994

Immunohistochemical localization of growth hormone receptor in cyclic human ovaries.

It has been demonstrated that co-administration of growth hormone (GH) augments ovarian response to human menopausal gonadotrophin, and GH itself increases steroidogenesis in cultured ovarian cells. It is not clear, however, whether the effects of GH on the ovary are direct or not. We performed immunohistochemistry using specific monoclonal antibodies against human GH receptor on 51 specimens of pre-menopausal human ovaries from various phases of the menstrual cycle to detect and localize GH receptors. Immunohistochemical localization of P450 aromatase and 3 beta-hydroxysteroid dehydrogenase was performed using these enzymes as immunohistochemical markers for steroidogenesis in these ovaries. GH receptor immunoreactivity was observed in luteinized granulosa cells in corpora lutea in the luteal phase, which are considered to be active in steroid production. In the follicular phase, GH receptor immunoreactivity was detected in the granulosa layer of only three out of 35 antral follicles. These results demonstrate that immunoreactivity of GH receptor is present in human ovaries, suggesting a direct action of GH on human ovarian functions, especially during luteal phase.

3-Hydroxysteroid Dehydrogenases↗
PubMed1994

Immunohistochemical distribution of progesterone, androgen and oestrogen receptors in the human ovary during the menstrual cycle: relationship to expression of steroidogenic enzymes.

In order to characterize immunohistochemically the possible in-situ effects of gonadal steroid hormones in the human ovary during the menstrual cycle, we immunolocalized progesterone (PR), androgen (AR) and oestrogen (ER) receptors in 50 normal cycling human ovaries, and examined the relationship between these findings and the cellular localization of steroidogenic enzymes including cytochrome P-450 cholesterol side-chain cleavage (P-450scc) enzyme, 3 beta-hydroxysteroid dehydrogenase (3 beta HSD), cytochrome P-450 17 alpha-hydroxylase (P-450c17) and cytochrome P-450 aromatase (P-450arom). A large number of stromal cells were positive for AR, regardless of the distance from a follicle. No steroidogenic enzymes were observed in the stromal cells. In the pre-antral follicle, AR was observed in the theca cells. P-450scc, 3 beta HSD and P-450c17 were sporadically expressed in the theca cells in relatively large-sized pre-antral follicles. ER was positive in the granulosa cells only in the P-450arom-positive antral or pre-ovulatory follicle, which is likely to be a selected follicle. In the corpus luteum, in the period from ovulation to the mid-secretory phase, PR immunoreactivity was observed in a large number of both the luteinized granulosa and the theca cells. All steroidogenic enzymes were observed in all corpora lutea, but ER was negative in any corpus luteum. In the atretic follicle, AR was present in the theca interna cells. P-450scc, 3 beta HSD and P-450c17 were observed in the theca interna cells in some atretic follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxysteroid Dehydrogenases↗